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General NPI Number Information
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NPI Number | 1487577219
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Entity Type | Individual
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Provider Name | COURTNEY LAM
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Gender | Female
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 11550 TARA BLVD
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City | HAMPTON
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State | GA
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Zip | 30228
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Country | US
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Telephone | 770-707-0711
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Fax |
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Provider Business Mailing Address
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Address Line | 3043 TURNER CHURCH RD
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City | MCDONOUGH
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State | GA
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Zip | 30252-2818
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Country | US
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Telephone | 678-510-8676
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003763
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License Number State | GA
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